U.S. patent number 5,478,333 [Application Number 08/207,017] was granted by the patent office on 1995-12-26 for medical dressing for treating open chest injuries.
Invention is credited to Richard E. Asherman, Jr..
United States Patent |
5,478,333 |
Asherman, Jr. |
December 26, 1995 |
Medical dressing for treating open chest injuries
Abstract
A medical dressing for treating open chest injuries, or other
injuries that compromise or could possibly compromise the pleural
space of the chest cavity. Specifically, a medical dressing used by
first responders to treat an open pneumothorax, treat and/or
prevent a tension pneumothorax from developing, remove the
accumulated blood of a hemothorax or re-inflating a collapsed lung
without invasive procedures and in some instances act as a conduit
for treating a tension pneumothorax or a collapsed lung with
invasive procedures.
Inventors: |
Asherman, Jr.; Richard E. (San
Antonio, TX) |
Family
ID: |
22768876 |
Appl.
No.: |
08/207,017 |
Filed: |
March 4, 1994 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
Issue Date |
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95047 |
Jun 10, 1993 |
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Current U.S.
Class: |
604/304; 128/887;
128/888; 604/307; 604/355 |
Current CPC
Class: |
A61F
13/143 (20130101); A61F 2013/15016 (20130101) |
Current International
Class: |
A61F
13/14 (20060101); A61F 013/00 () |
Field of
Search: |
;128/887,888
;602/42,58,59
;604/122,175,247,318-320,332,344,355,277,278,304,307,323,335,350
;137/846,850 |
References Cited
[Referenced By]
U.S. Patent Documents
Foreign Patent Documents
Other References
"Heimlich Valve for Chest Drainage", Medical Instrumentation AAMI,
vol. 17, No. 1, Jan.-Feb., 1983. .
Annals of Emergency Medicine #132, May 1993 edition..
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Primary Examiner: Green; Randall L.
Assistant Examiner: Clarke; Rob
Attorney, Agent or Firm: Gunn, Lee & Miller
Parent Case Text
Continuation-in-part application based on U.S. patent application
Ser. No. 08/075,047, filed on Jun. 10, 1993, now abandoned,
entitled: Medical Dressing for Treating Open Chest Injuries.
Claims
I claim:
1. A medical dressing comprised of:
a flexible body attaching means with a topside and an
underside;
said body attaching means having a center opening, wherein said
body attaching means is drawn into a flexible duct segment
extending in the direction of said topside of said body attaching
means, said flexible duct segment being generally tubular and
having an interior and an exterior side; and
a flexible single walled one-way valve tube having an interior and
an exterior side, a portion of said interior side at a first end of
said one-way valve tube is sealed to said exterior side of said
flexible duct segment of said body attaching means for enabling
passage of air in substantially one direction from said flexible
duct segment through said one-way valve tube.
2. The medical dressing of claim 1 wherein said flexible body
attaching means and said flexible one-way valve are substantially
impermeable to both air and fluids.
3. The medical dressing of claim 2 wherein a portion of said
underside of said flexible body attaching means is covered by a
double-sided adhesive material, said portion of said underside of
said flexible body attaching means covered by said double-sided
adhesive being attached to a tear-away backing, said flexible body
attaching means further comprising a non-adhesive finger hold, said
tear-away backing having a corresponding finger hold adjacent to
said finger hold of said body attaching means for assisting in
removing said tear-away backing from said underside of said body
attaching means.
4. The of claim 2 wherein said flexible, single walled one-way
valve tube further comprises a second air exit end with two
collapsible walls:
said second end being opposite said first end of said one-way valve
tube attached to said flexible duct segment; and
said collapsible walls being in a collapsed position when the
patient inhales so as to prohibit air from penetrating into the
patient's pleural space through the wound hole, and in a
non-collapsed position when said patient exhales, to allow the air
from said patient's pleural space to be expelled through said
flexible one-way valve tube.
5. The medical dressing of claim 4 wherein a portion of said
underside of said flexible body attaching means is covered by a
double-sided adhesive material, said portion of said underside of
said flexible body attaching means covered by said double-sided
adhesive being attached to a tear-away backing, said flexible body
attaching means further comprising a non-adhesive finger hold, said
tear-away backing having a corresponding finger hold adjacent to
said finger hold of said body attaching means for assisting in
removing said tear-away backing from said underside of said body
attaching means.
6. A medical dressing comprised of:
a flexible, impermeable body attaching means with a top-side, and
an underside, said flexible impermeable body attaching means having
a center opening drawn into a flexible impermeable duct segment
extending in the direction of said top-side of said flexible
impermeable body attaching means, said flexible impermeable duct
segment being generally tubular and having an interior and an
exterior side, said flexible body attaching means further
comprising a non-adhesive finger hold, said underside of said
flexible body attaching means is covered by a double-sided adhesive
material, said portion of said underside of said body attaching
means covered by said double-sided adhesive being attached to a
tear-away backing, said tear-away backing having a corresponding
finger hold adjacent to said finger hold of said body attaching
means for assisting in removing said tear-away backing from said
underside of said body attaching means;
a flexible, single walled impermeable one-way valve tube having an
interior and an exterior side, a portion of said interior side at a
first end of said one-way valve tube is sealed to said exterior
side of said flexible duct segment of said body attaching means for
enabling passage of air in substantially one direction from said
flexible duct segment through said one-way valve tube;
said flexible, single walled one-way valve tube further comprising
a second end with two collapsible walls;
said second end being opposite said first end of said one-way valve
tube attached to said flexible duct segment; and
said collapsible walls of said one-way valve tube being in a
collapsed position when the patient inhales so as to prohibit air
from penetrating into the patient's pleural space through the wound
hole and in a non-collapsed position when said patient exhales to
allow air from said patient's pleural space to be expelled through
said flexible one-way valve tube.
7. A non-invasive method of evacuating accumulated fluid and air
from the pleural space of a patient with a chest wound, comprising
the steps of:
positioning over said patient's wound hole a medical dressing
comprised of a flexible body attaching means having a center
opening drawn into a flexible duct segment, said duct segment
attached to a flexible, single walled one-way valve tube such that
exhaled air passes from said patient's wound hole through said
flexible duct segment and said flexible one-way valve tube in
substantially one direction;
securing said medical dressing to the skin of said patient
surrounding said wound hole;
inserting suction means into said flexible, single walled one-way
valve and said flexible duct segment to a position directly over
said wound hole;
securing disposal means to said suction means; and
engaging said suction means to suck said accumulated fluid and air
from said pleural space into said disposal means attached to said
suction means.
8. The method of claim 7 further comprising the step of:
positioning said patient on said patient's side having said wound
hole such that said fluid drains out of said pleural space through
said wound hole.
9. A method of treating a tension pneumothorax, comprising the
steps of:
inserting a catheter into the side of the chest of the patient
having a wound hole to allow for trapped air to be expelled from
the pleural space of said patient;
positioning over said catheter a medical dressing comprised of a
flexible body attaching means having a center opening drawn into a
flexible duct segment, said flexible duct segment attached to a
flexible, single walled one-way valve tube to protect said catheter
from moving in a manner detrimental to said patient; and
securing said medical dressing to the skin of said patient
surrounding said catheter.
Description
BACKGROUND OF THE INVENTION
1. Field of The Invention
Applicant's invention relates to multi-purpose medical dressings,
in particular, dressings for treating open chest injuries or other
injuries that compromise, or could possible compromise the pleural
space of the chest cavity. Specifically, a medical dressing used by
first responders to treat an open pneumothorax, treat or prevent a
tension pneumothorax from developing without invasive procedures,
evacuate the pooled blood in a hemothorax or re-inflate a collapsed
lung without invasive procedures, and, in some instances, act as a
conduit for treating a collapsed lung or a tension pneumothorax
with invasive procedures.
2. Background Information
FIG. 6 is a diagram of the chest cavity. When a person is shot or
stabbed in the chest, the wound often times penetrates a sufficient
distance into the chest cavity to puncture the parietal pleura,
visceral pleura, and the lungs. In some cases two wound holes are
formed, an entry and an exit hole. A wound hole(s) that penetrates
the chest cavity and parietal pleura allows air and/or blood to
flow freely into the chest cavity, the pleural space, and possibly
the lungs.
The condition wherein air penetrates into the pleural space between
the lung and the chest wall through a wound hole in the chest wall
is an open pneumothorax. When an open pneumothorax occurs, the
normal mechanism by which the lung expands is lost; i.e., the fluid
adhesion of the pleural surface of the lung to the pleural surface
of the chest wall. Thus, the affected lung does not expand when the
patient inhales and respiratory distress becomes severe and
possibly fatal. For patients with an open wound to the chest, the
severity of the open pneumothorax that develops can be minimized by
sealing the open wound via an occlusive bandage prior to transport.
The occlusive bandage is used to eliminate air penetrating into the
pleural space through the wound hole when the patient inhales. If
the intake of air into the pleural space is not entirely
eliminated, additional air will be trapped in the pleural space,
thus causing the pressure in the affected chest cavity to rise. If
the pressure in the chest cavity exceeds normal pressure, blood
flow from the heart to the lungs may be halted, with death rapidly
following. Thus, it is imperative that when treating an open
pneumothorax, that the wound is appropriately sealed in a manner
which eliminates air from penetrating into the pleural space
through the wound hole.
The current day medical procedures used by first responders to
treat an open pneumothorax are occlusive type dressings. For
example, (1) petrolatum gauze dressing, (2) a sterilized aluminum
foil dressing, or (3) a folded universal dressing placed over the
wound. The gauze dressing, foil or universal dressing is taped to
the skin on all four sides of the wound. By taping the dressing on
all four sides, the first responder is attempting to eliminate air
penetrating into the pleural space through the wound. Yet, in most
instances, this type of dressing is ineffective. It either (1) does
not totally eliminate air entering the pleural space through the
wound; (2) eliminates air penetrating into the pleural space
through the wound yet does not allow the already trapped air to
escape; or (3) a combination of both. These defects could cause a
more serious tension pneumothorax to develop which leads to
respiratory insufficiency and heart failure. Consequently, a need
exists for a method and apparatus for successfully treating an open
pneumothorax that can be used by first responders, which totally
eliminates the intake of outside air into the pleural space via the
wound hole yet allows already trapped air to escape.
In addition to developing a tension pneumothorax by using defective
dressings as discussed above, a patient with an open chest wound
and a severe lung laceration may also develop a tension
pneumothorax in a different manner. For instance, the bandage may
have eliminated air from entering the pleural space through the
wound hole, yet if lacerated, the lung will continue to leak air
into the pleural space. Consequently, every time the patient
inhales, more air becomes trapped in the pleural space, causing
more pressure to be exerted on the lacerated lung. This increased
pressure on the lacerated lung forces the lung to collapse until
reduced to a ball 2-3 inches in diameter. At this point of
collapse, pressure in the affected chest cavity begins to rise, the
collapsed lung is pressed against the heart and the lung on the
opposite side, compressing the remaining uninjured lung. If the
pressure in the chest cavity exceeds the normal pressure of the
blood returning to the heart, blood flow from the heart to the
lungs may be halted, with death rapidly following.
To successfully prevent a tension pneumothorax from developing, the
air flow into the pleural space via the wound hole must be
eliminated, but the air coming from the lacerated lung must be
allowed to escape the pleural space via the wound hole. The method
of treatment currently used by first responders is the same type of
dressing used to treat an open pneumothorax except it is taped on
only three sides of the wound. The untaped side of the bandage
theoretically allows air to exit the pleural space through the
wound hole when the patient exhales. As the patient inhales, the
three sided dressing theoretically collapses against the wound,
thus prohibiting air from entering the pleural space through the
wound hole.
In most instances, three sided dressings are ineffective.
Initially, the amount of blood that normally accompanies the chest
wound prohibits the tape from securely attaching the dressing to
the patient. Secondly, when the petrolatum gauze dressing is
opened, it becomes creased, making it less form fitting to the
body. Consequently, air can both enter and exit the chest cavity
because the petrolatum gauze is not sucked against the wound when
the patient inhales. Petrolatum is also necrotizing to the lung
tissue. If petrolatum penetrates the wound and contacts the lung
tissue, the lung tissue may die. Finally, for less experienced or
less trained first responders, their common protocol when treating
any type of chest wound is to apply a totally occlusive, four-sided
bandage instead of a non-occlusive three-sided dressing. If a
four-sided bandage is used in conjunction with a lacerated lung, or
an already developing tension pneumothorax, the results can be
deadly. Consequently a need exists for a medical dressing for use
by first responders that effectively treats both an open
pneumothorax and a tension pneumothorax and accordingly does not
require the first responder to determine if a three sided or four
sided bandage is required.
Other than the above described ineffective three sided or four
sided dressings, the only other procedure currently used to treat
or prevent a tension pneumothorax from developing is an invasive
procedure using a needle thoracentesis (FIG. 1O) that may only be
performed by highly trained medical professionals. Therefore, a
need exists for a method and apparatus for treating or successfully
preventing a tension pneumothorax from developing which does not
require invasive procedures. The apparatus must allow air to escape
from the pleural space, yet not allow air to enter the pleural
space through the wound hole.
In some instances, medical personnel having the training to perform
a needle thoracentesis are on the scene. A needle thoracentesis is
an invasive procedure to immediately decompress a tension
pneumothorax. It is performed when a tension pneumothorax has
progressed to a point that the affected lung has completely
collapsed, putting pressure on the mediastinum, which affects the
operation of the heart and the good lung.
The needle thoracentesis procedure consists of taking a large bore
catheter, 14 gauge or larger, and inserting it into the second
intercostal space in the mid-clavicular line of the patient's chest
on the side of the tension pneumothorax. The catheter is inserted
until trapped air begins to escape from the plural space. The
catheter remains in the chest to allow all pressure to escape.
After air stops escaping through the catheter, it is also removed.
After the catheter is removed, if a tension pneumothorax begins to
again develop, it becomes necessary to repeat the above procedure
which is very time consuming and cost ineffective. Furthermore, on
the battle field, medics do not have the time to continually repeat
the needle thoracentesis on several patients. Consequently, a need
exists that would allow a mechanism for the catheter to be
maintained in the chest yet, securing the catheter in such a manner
that it does not become inoperable and possibly forced into a
position harmful to the patient.
In addition to a tension pneumothorax, a patient with a chest wound
may also experience a hemothorax. A hemothorax is the presence of
blood in the pleural space. The blood in the pleural space may come
from lacerated vessels in the chest wall, from lacerated major
vessels within the chest cavity itself, or from a lacerated lung.
In a hemothorax, the pleural space becomes filled with blood.
Normal lung expansion does not occur, and the lung itself is
compressed, thus less air is inhaled. In addition, significantly
less blood may be available to carry the reduced level of oxygen to
the patient's vital organs.
To treat a hemothorax, the blood must be removed from the pleural
space to allow the lung to expand to its normal capacity. Current
day treatment of a hemothorax by a first responder includes
application of an occlusive dressing over the wound, positioning
the patient onto the injured side, thus limiting the pooled blood
to the wound side of the chest cavity, immediate ventilatory
support, administration of oxygen, and immediate transportation to
the hospital. Treatment by first responders does not currently
include removal of the accumulated blood from the pleural
space.
Removal of the blood in the pleural space does not occur until the
patient is in the hospital. Once in the hospital, a chest tube is
inserted into the wound and negative pressure, i.e. suction, is
applied to remove the accumulated blood in the pleural space. If a
sufficient quantity of blood accumulates in the pleural space
before the patient arrives at the hospital, the lacerated lung may
collapse. Therefore, it is imperative that the blood be removed
from the pleural space as soon as possible. Consequently, a need
exists for a method and apparatus to be used by a first responder
for removal of blood in the chest cavity.
An unwanted result of a tension pneumothorax and a hemothorax is a
collapsed lung. Currently, a collapsed lung is only re-inflated
through invasive procedures in the hospital. First responders at
this time do not treat a collapsed lung. If a collapsed lung is not
treated, it can lead to further respiratory difficulties in an
already traumatized patient. Consequently, a need exists for a
method and apparatus for successfully re-inflating a collapsed lung
by a first responder.
Finally, medics on the battlefield face dilemmas everyday due to
the limited space in a medic's pack. Consequently, when the bandage
used to treat often encountered wounds on a battlefield is compact,
the compactness increases each wounded soldier's chances of
survival. Chest wounds are one of the most encountered injuries on
a battlefield. Consequently, a need exists for a small, compact yet
efficient bandage that can be used on the battlefield to treat open
chest wounds. In addition to being compact, the bandages must
require little attention after application, and continue to operate
for at least an hour after application due to distances from the
battlefield to the nearest care facility.
DESCRIPTION OF THE PRIOR ART
U.S. Pat. No. 4,465,062 entitled "Non-Invasive Seal for a Sucking
Chest Wound" issued to Versaggi, et al on Aug. 14, 1984, discloses
a rectangular shaped bandage attached to a teflon coated check
valve by a flange and ring seal mechanism. The check valve is
sealed within a hard plastic dome.
The Versaggi device is an unsatisfactory bandage due to the hard
plastic dome. Initially, the plastic dome bars access to the check
valve. If the check valve becomes clogged and inoperable, exhaled
air will be trapped in the pleural space of the lungs. Through
malfunction of the check valve of the Versaggi device, a tension
pneumothorax could develop or, if initially treating a tension
pneumothorax, further complications such as collapsed lungs and
heart failure could be encountered. Thus, death could occur simply
because the check valve of the Versaggi apparatus is
inaccessible.
Secondly, because of the inaccessibility, the care provider must
pay constant attention to the Versaggi device. If the Versaggi
device malfunctions, it must be removed and replaced. On the battle
field, constant attention is not practical, nor is time available
to replace a bandage. On the battle field, medics dress the wounds
and send the wounded to the nearest care facility. At times, it may
take over an hour for the wounded patient to be transported and
treated by personnel with more advanced equipment. Consequently, if
the check valve malfunctions and it goes unnoticed, a tension
pneumothorax may develop and the person may die because the
inoperability of the check valve.
Third, the hard plastic dome also prevents the Versaggi device from
being used in conjunction with suction devices or a needle
thoracentesis. Consequently, neither a hemothorax nor a collapsed
lung could be treated with the Versaggi device. Rather, these life
threatening concerns would have to wait until the patient arrived
at a hospital or care facility where invasive procedures could be
performed.
In addition to accessibility, Versaggi's hard plastic dome raises
other problems. For instance, the plastic dome could break during
storage and lacerate the base or check valve, thus rendering the
Versaggi device inoperable. The plastic dome also precludes use of
the Versaggi device on the down side of a patient. The hard plastic
will put undue pressure on and around the wound, causing further
damage to the traumatized tissue. In the worst case scenario, the
patient's weight could break the plastic dome, cutting the patient
or lacerating the valve and rendering the device inoperable. Again,
if the patient were not being closely attended, the patient could
die due to the malfunction.
The manner in which the Versaggi device is constructed makes it
even more undesirable. The check valve has a flange at its lower
end which fits through a hole in the rectangular bandage. The
flange in conjunction with a ring seal maintains the check valve
adjacent to the hole in the bandage. If the ring seal and
rectangular bandage are not securely joined, air will penetrate the
wound hole via the ineffective seal between the ring seal and
bandage. Furthermore, the ring seal precludes use of the Versaggi
device on large wounds. If the diameter of the wound hole is larger
than the diameter of the ring seal, the height of the ring seal
will create a space in which air may be trapped between the bandage
and the wound which is not within the diameter of the ring seal.
The trapped air would continually penetrate the wound and a tight
seal would never be perfected between the valve and the wound due
to the trapped air above the wound not covered by the ring
seal.
Finally, the size of the Versaggi apparatus further limits its use.
Current day gauze/aluminum bandages are envelope size and a number
of them easily fit into a medic pack or other emergency personnel
equipment. The Versaggi apparatus with its plastic dome is
approximately 5-10 times thicker than the current day bandages.
Just the size difference alone automatically ensures that fewer of
the Versaggi devices could be packed than current day bandages.
This smaller number would be detrimental to several soldiers on the
battle field or individuals who were involved in a situation where
numerous other individuals were also injured and received chest
wounds.
U.S. Pat. No. 4,717,382 entitled "Non-Invasive Apparatus for
Treating a Sucking Chest Wound" issued to Clemens, et al on Jan. 5,
1988, discloses a reusable apparatus comprised of a compartment for
collecting fluid positioned beneath a one-way valve. Initially, the
Clemens device is impractical and uneconomical. With today's health
concerns and rising deaths from AIDS, care providers would not
reuse the Clemens device. Consequently, the cost of manufacturing a
reusable device far exceeds the one-time use cost.
The manner in which the Clemens device is maintained adjacent to
the wound hole is also impractical. The connection (1) takes too
long to secure, (2) could easily be shifted away from the wound
hole rendering the device inoperable, and (3) a patient may be too
large to use the Clemens device.
The Clemens compartment for collecting fluid is also an undesirable
feature. It is positioned directly above the wound hole. This
position is detrimental to the patient as some of the fluid may be
sucked back into the wound when the patient inhales. Furthermore,
health concerns teach away from collecting fluids that may contain
life threatening contaminants in this manner wherein the
health-care provider may contact the body fluid directly when the
device is removed.
Like the Versaggi device, Clemens also cannot be used in
conjunction with a suction device to treat a hemothorax or a
collapsed lung. Although Clemens does allow for an alternative
device that can be connected to suction means, this suction is only
used to remove the fluid from the fluid holding compartment.
Clemens could not be used in conjunction with suction means to
aspirate air or fluid from the chest to treat a hemothorax or a
collapsed lung because the distance of the catheter from the wound
that Clemens' structure requires would prohibit effective suction
of the pleural contents. Due to the valve distance from the wound
hole, Clemens could also not be used in conjunction with a needle
thoracentesis.
Again, like the Versaggi device, the Clemens device also suffers
due to its bulkiness. In many instances, i.e., medic bags, space is
of the essence. Consequently, the smaller the apparatus, the larger
the number available in the war zone. In comparison to the Clemens
device, at least 10-15 foil/gauze dressings could be packed. In a
medic's pack on the battle field, this difference could be life
endangering to dozens of soldiers. Due to the bulkiness and
hardness of the Clemens device, it could also not be used on the
downside of a patient for the same reasons as those listed above in
relation to Versaggi. Finally, Clemens' inflatable seal can not be
used on the battlefield due to the high probability of aeromedical
evacuations. Changes in altitude will cause the inflation level to
change which could rupture the inflatable seal, rendering the
device inoperable.
SUMMARY OF THE INVENTION
This invention finds great utility in treating an open
pneumothorax, treating and/or preventing a tension pneumothorax,
treating a hemothorax and re-inflating a collapsed lung without
invasive procedures, and in some cases acting as a conduit to treat
a tension pneumothorax and a collapsed lung with invasive
procedures. In accordance with this invention, a one-way air valve
is attached to a body attaching means with an adhesive underside.
The center of the body attaching means translates into a generally
cylindrical duct segment that in use is positioned near and
projects outwardly from the wound hole such that the air expelled
from the wound hole flows into the duct segment. The interior of
the bottom portion of the one-way air valve is attached to the
exterior of the duct segment by an adhesive that is capable of
being sterilized.
When Applicant's medical dressing is used to treat an open
pneumothorax or treat and/or prevent a tension pneumothorax, the
duct segment of the body attaching means is positioned over the
wound hole so that air escaping from the wound passes through the
duct and exits through the one-way valve. The adhesive underside of
the body attaching means is attached to the skin surrounding the
wound to maintain the medical dressing in place. As the patient
exhales, air is forced from the pleural space, through the wound
hole, through the duct segment and exits through the air exit end
of the one-way valve. The force of the exhaled air causes the sides
of the one-way valve to part so that the air may escape through the
air exit end. The sides of the one-way valve collapse back against
each other after the air is expelled through the air exit end of
the one way valve. As the patient inhales, the unique shape of the
one-way valve does not allow air to re-enter the wound through the
one-way valve. Thus, Applicant's medical dressing acts as an
occlusive bandage when the patient inhales, yet as a non-occlusive
bandage when the patient exhales.
The medical dressing may also be used to treat a hemothorax. The
medical dressing is placed over the wound as discussed above in
treating an open pneumothorax or tension pneumothorax. The tip of a
suction catheter or other suction producing device is inserted into
the one-way valve and duct segment to a position directly above the
wound to remove fluid, air or even a blood clot that is blocking
the wound hole. In this procedure, the suction catheter does not
penetrate the wound hole.
The medical dressing may also be used in conjunction with suction
producing devices to re-inflate a lung that has collapsed. Again,
the medical dressing is placed over the wound hole as discussed for
treating of a pneumothorax. A suction producing device is inserted
into the one-way valve. The lung is re-inflated by the negative
pressure produced by the suction producing device directly over the
wound hole. Again, in this procedure, the suction producing device
is not inserted into the wound hole.
Finally, the medical dressing may also be used as a conduit to
treat a tension pneumothorax or a collapsed lung with invasive
procedures. In this procedure, a catheter is inserted into the
second intercostal space in the mid-clavicular line of the
patient's chest on the side that the tension pneumothorax has
developed. The catheter is inserted until trapped air or blood
begins to escape from the pleural space through the catheter. Tile
catheter remains in the chest until air stops escaping from the
chest. Applicant's medical dressing is applied to the skin
surrounding the catheter such that the one-way valve encircles the
catheter and provides support to the catheter, protects the
catheter from being bumped or moved into a position that would be
detrimental to the patient and also assures the catheter will not
kink.
The simplicity of Applicant's device assures it is economical and a
feasible replacement for the ineffective aluminum/gauze dressings
that are currently being used. Furthermore, the size of Applicant's
medical dressing assures its use on the battlefield in other
medical emergencies wherein space is in limited supply.
BRIEF DESCRIPTION OF THE DRAWINGS
FIG. 1 is a cut-a-way side view of the medical dressing.
FIG. 2 is a perspective view of the medical dressing.
FIG. 3 is a top view of the medical dressing.
FIG. 4 is a side view of the medical dressing.
FIG. 5 is a underneath view of the medical dressing.
FIG. 6 is a cut-away of the chest showing the chest cavity.
FIG. 7 is a perspective/cut-a-way view of the medical dressing in
use.
FIG. 8 is a perspective view of the body attaching means without
the one-way valve attached.
FIG. 9 is a perspective view of the Applicant's medical dressing in
conjunction with a suction device.
FIG. 10 is a perspective view of the Applicant's medical dressing
in conjunction with a catheter.
DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENT
Referring to FIGS. 1,2 and 3, medical dressing (10) is comprised of
one-way valve (20) and body attaching means (12) whose center
translates into duct segment (16). Body attaching means (12) has a
top side (17) and an underside (19) (See FIG. 5). Referring to FIG.
5, underside (19) of body attaching means (12) includes
non-adhesive underside section (30) and adhesive underside section
(14). Referring again to FIGS. 1 and 2, tear-away backing (13)
covers underside (19) and is attached to adhesive underside section
(14). One-way valve (20) has sides (28a-b), lower end (24), and air
exit end (26).
Body attaching means (12) has non-adhesive finger hold (11)
positioned proximate to non-adhesive finger hold (15) of tear-away
backing (13), such that the care provider may pull non-adhesive
finger hold (15) away from non-adhesive finger hold (11) to remove
tear-away backing (13) from adhesive underside section (14).
Referring to FIG. 1, the center of body attaching means (12)
translates into duct segment (16). Duct segment (16) allows exhaled
air from the wound to pass through body attaching means (12), into
one-way valve (20) and through air exit end (26) of one-way valve
(20). Referring to FIG. 8, duct segment (16) is comprised of first
conical section (40), cylindrical section (42) and second conical
section (44). The interior of lower end (24) of one-way valve (20)
is attached to the exterior of cylindrical section (42) of duct
segment (16) by an adhesive material that is capable of being
sterilized.
One-way valve (20) is made of natural rubber, vinyl or other
materials which will allow sides (28a-b) of one-way valve (20) to
separate when air is expelled from the wound hole through the
interior of one-way valve (20), yet allows sides (28a-b) to
collapse against each other after the air has been expelled. The
preferred material being natural rubber. Body attaching means (12)
is made of a flexible polymeric material capable of being
sterilized and yet sufficiently rigid such that the sides of duct
segment (16) do not collapse against each other during normal
operation. The preferred being a styrene block copolymer that is
impermeable to both air and fluid such as Kraton 62700 Series
Styrene Block Copolymers Product Nos. 2705, 2706 and 2712 by Shell
Oil Company. Adhesive underside segment (14) is created by applying
most non-air permeable hypo-allergenic adhesives to underside (19)
of body attaching means (12), the preferred being a doubled-sided,
pressure sensitive adhesive Product No. 1524 by 3M. One-way valve
(20) and body attaching means (12) may also be made of clear
materials that will enable the care provider to view the wound even
after medical dressing (10) is applied.
Body attaching means (12) and one-way valve (20) are constructed of
pliable, flexible materials so that medical dressing (10) will
adhere to any contour of the human body, including the female
breast or a well developed male chest. This is an important feature
as current day medical dressings are not normally capable of
conforming to these areas. The flexibility of one-way valve (20)
also allows medical dressing (10) to be attached to the downside of
the patient. Although one-way valve (20) may not open to allow air
to be expelled because the patient is lying on the valve, the
flexibility of body attaching means (12) and one-way valve (20) of
medical dressing (10) assures that the tissue surrounding the wound
will not be further traumatized due to hard or unbendable materials
putting pressure on the patient's traumatized skin, and Applicant's
device will be operable when (1) the patient is not lying on it.
The flexibility of one-way valve (20) and the manner in which duct
segment (16) of body attaching means (12) is attached to one-way
valve (20) assures medical dressing (10) can be packaged in a
generally flat, envelope manner. In this manner, medical dressing
(10) is either as small as, or possibly smaller, than current day
aluminum/gauze dressing. Consequently, in medical situations where
supply space is in short demand, at least the same number of
medical dressings (10) may be packed as prior art gauze/aluminum
dressings. This is specially important in medic packs utilized in
war zones or on battle fields.
Medical dressing (10) may also be constructed such that one-way
valve (20) and body attaching means (12) are one sheet of pliable
plastic and/or other material that is non-permeable yet capable of
being sterilized.
To use medical dressing (10) in a non-invasive procedure, the
patient's skin around the wound hole is wiped clear of blood and
sweat to enhance the adhesive effect of adhesive underside section
(14) of underside (19) of body attaching means (12). Tear-away
backing (13) is removed from adhesive underside segment (14) of
underside (19) of body attaching means (12) by pulling finger hold
(11) of body attaching means (12) in an opposite direction from
finger hold (15) of tear-away backing (13). Duct segment (16) of
body attaching means (12) and one-way valve (20) are positioned
over the wound hole (see FIG. 7). This placement assures duct
segment (16), one-way valve (20), and air exit end (26) of one-way
valve (20) are appropriately positioned over the wound hole.
Adhesive segment (14) of underside (19) of body attaching means
(12) is then pressed against the skin to assure medical dressing
(10) attaches securely to the skin of the patient. As the patient
exhales, air is released through duct segment (16) via body
attaching means (12) into one-way valve (20) and out through air
exit end (26) of one-way valve (20) by the separation of sides
(28a-b) of one-way valve (20). After the exhaled air exits through
air exit end (26) of one-way valve (20), sides (28a-b) of one-way
valve (20) collapse back against each other, thus preventing air
from returning through one-way valve (20) when the patient inhales.
Additionally, as the patient inhales, sides (28a-b) of one-way
valve (20) are sucked against each other, further preventing air
from entering the wound through one-way valve (20). If the patient
has a multitude of chest wounds, including wounds on the downside,
medical dressing (10) is applied to each wound.
When the patient exhales, and one-way valve (20) is operable, sides
(28a-b) of one-way valve (20) make an audible flutter. If body
attaching means (12) and one-way valve (20) are made of a clear
material, the care provider may also visually determine if the
one-way valve is clogged. Because of the accessibility of one-way
valve (20), if one-way valve (20) becomes inoperable due to
clogging with blood or other fluids, a suction device can be
inserted into one-way valve (20) to immediately remove any material
that may be causing one-way valve (20) to be inoperable without
breaking the seal created between the wound and one-way valve (20)
or requiring replacement of medical dressing (10).
Referring to FIG. 9, if a hemothorax or a collapsed lung is to be
treated without invasive procedures, suction device (S) is inserted
into one-way valve (20) and duct segment (16) by forcing sides
(28a-b) of one-way valve (20) apart and inserting suction device
(S) into one-way valve (20). Tip (T) of suction device (S) is
positioned directly above the wound hole. In this manner, suction
device (S) removes fluids, air and blood clots which may be on the
surface of or being expelled out of the wound hole. If a hemothorax
is being treated, the patient may also be turned on the side which
has the wound. In this position, blood may drain from the pleural
space through the wound hole which suction device (S) may
collect.
FIG. 10 illustrates medical dressing (10) being used as a conduit
for a catheter (C). If a severe tension pneumothorax or a collapsed
lung is to be treated with invasive procedure, the catheter (C) is
inserted into the patient's chest near the second intercostal space
(between the second and third rib) in the mid-clavicular line (an
imaginary line going straight down from the center of the clavicle)
of the patient's chest on the side of the tension pneumothorax or
collapsed lung until trapped air begins to escape from the pleural
space. Catheter (C) remains in the chest until all pressure is
relieved. Medical dressing (10) is positioned such that one-way
valve (20) and duct segment (16) encircle catheter (C). To use,
sides (28a) and (28b) of one-way valve (20) are forced apart and
catheter (C) is inserted into one-way valve (20). Adhesive
underside segment (14) of underside (19) of body attaching means
(12) is then applied to the skin securing medical dressing (10)
such that one-way valve (20) of medical dressing (10) supports
catheter (C). Catheter (C) can remain in the patient's chest for an
unlimited amount of time. Leaving catheter (C) in the lung assures
that a crisis situation will not arise again. By using medical
device (10), catheter (C) is sufficiently protected and supported
such that catheter (C) will not be moved into a position that could
be detrimental to the patient.
Although the invention has been described with reference to
specific embodiments, this description is not meant to be construed
in a limited sense. Various modifications of the disclosed
embodiments, as well as alternative embodiments of the inventions
will become apparent to persons skilled in the art upon the
reference to the description of the invention. It is, therefore,
contemplated that the appended claims will cover such modifications
that fall within the scope of the invention.
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